Help with Starting a Testing Regime....

[adm]

I was diagnosed with T2 earlier this week, and although I don't get an initial appointment with a diabetic nurse until the 8th of may, I have gone and bought a meter and some strips so I can start monitoring what's actually going on in my body and have the data to hand to make informed decisions.

So I got a Bayer Contour USB meter. Ordered online yesterday afternoon, and delivered this morning. I chose this for the ability to hook it up to my computer and the embedded software for viewing trends etc...( I have a science and engineering background so I want to be able to play with data!)

Anyway. My first test this morning was before I ate or drank anything - a fasting test, right? The result of this was 9.0 mmol/L. I don't really have anything to compare this against - the only other data point i have is that when i saw my GP, he mentioned my "sugars were 15", so I presume that would also have been 15 mm/L. That would also most likley have been a fasting test as my previous blood test at the GP was early morning before any food - although I'd probably had tea (with no sugar).

I guess my question is, when is the best time to test, and how often? Should I test before every meal and then 2 hours afterwards and keep a food log as well so that I can determine the effects of different food types? Should I test before I go to bed as well as on waking?

Any thoughts on how best to structure a testing regime? I know this is going to cost a few quid in test strips, but I'd rather test too often over the first few months until I figure out what's actually going on...

 

[cugila]

I guess my question is, when is the best time to test, and how often? Should I test before every meal and then 2 hours afterwards and keep a food log as well so that I can determine the effects of different food types? Should I test before I go to bed as well as on waking?

Well done, the first person I have seen to ask the question and answer it all in one go !! What you have stated is ideal for at least a month or so on a daily basis.

Any thoughts on how best to structure a testing regime? I know this is going to cost a few quid in test strips, but I'd rather test too often over the first few months until I figure out what's actually going on...

If you have to buy your own strips then try Ebay....a good source of cheaper strips.

Ken

 

[adm]

Thanks!

This is proving interesting.....

I started off this morning at 9.0, had what I'd consider to be a healthy breakfast - a big bowl of Nuts, Fruits & Seeds muesli and a pot of tea. Two hours later, my BG was 15.0!

Before lunch, it was down to 8.2. I had a big cheese and ham omelette. 2 hours later, it was down to 6.5!

So, when testing to work out how tolerant I am to certain foods, I presume it makes sense to test the same food a few times, just to make sure that the results aren't skewed by any other factors... so I'll try the muesli again tomorrow morning, but I was shocked at how high it made the BG number go.

One question - with T2, is it safe to say that we aren't really all that concerned about short term "spikes" in BG level - more the longer term effect, and that's why we wait 2 hours after eating to test?

 

[cugila]

Personally, I can't tolerate Muesli, it rockets my Bg levels. Loads of carbs....You say a big bowl, maybe you need to reduce the portion sizes......my breakfast portion sizes are around 20g only. You need to weigh the food and work out the amount of carbs you are actually consuming. Some fruit needs to be limited as well. Was this a Commercial product you used or just your own ?

Very little carbs in the Cheese and Ham Omelette so that would be OK, no high levels.

The point of testing at 1 hr as well as 2 hrs is to find what 'spikes' your Bg levels. I want to avoid them as much as possible, so I previously tested frequently to identify those foods. Then they were either removed or reduced from my diet. Testing is the only way to find out.

The reason we wait for 2 hrs is to see that the level pre meal has gone back after 2 hrs to something like the same levels.....not exact....just similar. That way you know that what you are eating can be tolerated and that meal is OK.

You need to keep a food diary and records of Bg levels so you can see which foods affect the levels, good or bad.

Ken.

 

[justfoundout]

adm

If my bs shot that high with something I certainly wouldn't try it again - I'd try something else entirely! How many carbs were in the bowl of cereal - my guess is around 40? That's nearly my daily limit across all meals and snacks (not advocating you go that low but using as a comparison). Get yourself a Collins Gem calorie counter book (less than a fiver) and it will give you the insight you need into relative carb contents. By doing that I say yes to blackberries and no to pineapple for example. It's also important to measure the portion size. I'm amazed at how small a portion can be.
Protein works better for me for breakfast along with a bit of home made low flour free bread sometimes. Eggs and bacon in the morning is no longer a luxury but a way of life. If time is an issue I boil 2 the night before and take with me with ham.
The 2 hour measure is on the basis if we were not T2 our bodies would produce sufficient insulin which would work properly to bring sugar levels back down to what they were prior to the food (around 4.5 to 5).
If you are eating to the meter - believe the meter....
M

 

[sugarless sue]

If you are eating to the meter - believe the meter....
M

Yes.....but...Some foods cause a 'spike' at one hour reading then, by two hours appear fine.

Some foods, especially if containing a lot of fat, 'the pizza effect', can seem fine at two hours but continue to rise at three, four hours or even longer.

 This is why newly diagnosed Type 2's need to do extensive testing in the early days to see what effect the foods they eat have on their blood sugar levels.

 

[adm]

So the bowl of Muesli was probably 100g portion size or so......and now that I have checked the box, it says 58.4g of carbs per 100g, of which 24.3g are sugar.

This is "Dorset Cereals Fruit, Nuts & Seed". When I bought it, I just looked at the ingredients, saw no listing for sugar and presumed that as the cereal was mainly oat flakes, it should be slow release "good" carbs which wouldn't cause a problem.

Looks like I'm going to have to learn better. When I did the Montignac diet years ago, "good" carbs were often on the breakfast menu - normally I'd have some stoneground wholemeal bread with marmite (no butter). I'll have to try that and see how that affects the meter.

Of course, bacon and eggs for breakfast is a favourite anyway. And I suppose (most/some) fruits and Greek yoghurt would be an option too.

When I started this, I thought that a limited amount of unprocessed carbs would be good....but I'll just have to test, test and test again to find out what actually works for me.

I like the idea of doing a 1hr test after eating too. That should probably capture the "peak" value of whatever I'm eating.

 

[cugila]

OMG............ :shock: :shock: :shock:

A lesson learned I think........ Have you read the guide we isssue to Type 2 newbies, we post it all over the place. If you can't find it I can post it here. Always check the nutrition information....not just the ingredients. As you found they can be misleading.

As Sue stated, some foods will 'spike' much later than 1 and 2 hrs.....so you need to be wary.

Ken.

 

[hanadr]

adm
you are dealing with loads of new kinds of data all at the same time, which is confusing even for someone numerate..
I'll answer a bit for you
"Spikes" are now thought to be at least as dangerous as average levels which are consistently a bit high.
You might find it interesting to know that non-diabetic blood glucose hovers around 4.7 and doesn't vary much or for long. Also those non-diabetics who have Bg levels slightly above the average level, tend to develop "diabetic complications"
This is why it's my personal opinion that BG targets for diabetics are set too high [Even more interesting when you learn how those targets were chosen originally].Ken will, I'm sure give you the usual recommended targets, which are published by Diabetes UK.
I have set my own personal target of "never over 6". Being human, I miss sometimes, but I can maintain it most of the time. I have been working on it for some time though.
Good luck with it all.
Hana

 

[cugila]

adm
Ken will, I'm sure give you the usual recommended targets, which are published by Diabetes UK.

The targets are actually the 2010 guidelines compiled and published by the National Institute for Clinical Excellence and published on other websites including this one Diabetes.co.uk which are of benefit to all Diabetic's.

Hana

Ken.

 

[justfoundout]

adm
The biggest lesson so far for me is that I have to learn to think differently. My pre-diabetes diet was healthy for a non-diabetic person but for me that old diet now equates to poison. It was making me ill and therefore I've thrown away my old rule book. I ate wholemeal only, lots of fruit and veg, the cereal that you will hopefully find a new home for, lentils etc
Now I've started again and relearning how to feed my body and keep my sugars as low as I can whilst still having an interesting and varied diet. It is about making changes but still fitting in. for example I had girlfriends staying over the weekend. Pete's fish & chips is great so that was the Friday eat-in. But I had the fish avoiding the batter and threw some chip shaped celeriac into the oven with some olive oil. Delicious fish and chips just different! And my level after 1 1/2 hours was 5.4. I try and compromise on the measurement time and go for 1 1/2 hours after starting to eat.
The other big lesson is that diabetes is a very individual thing. Some people can eat something and it is ok for them, but that doesn't mean it will be ok for me. For example shop and resaurant breads, even in small amounts, play havoc with my levels so now I make bread that is kind to my diabetes. Happy learning. M

 

[SophiaW]

Hana, "never over 6" is a strict target. I'm a non-diabetic and my readings can go over 8 after a meal.

 

[adm]

Good advice folks.....thanks a lot!

Now the really important question ......what about Curry?

I CANNOT live without curries. I presume that most meat dishes shouldn't be too bad, but the rice and breads are going to have to go and maybe be replaced by veggie side dishes...? It's going to be interesting finding out what I can and can't eat from my favourite Indian restaurants.....

 

[justfoundout]

adm
Ah curry - that has been the only meal out that has caused havoc with bs levels. Over 11 and bad the next day. I completely avoided breads, rice and stuck to tandoori and veg dishes. Painstakingly explained to the waiter that I am allergic to sugar and flour and could chef avoid in sauces (this explanation I have found works everywhere else I have been including thai). Didn't work. So that curry place will not see me again. Others may be able to offer a better curry house strategy. Do you have a regular place where the staff know you? Maybe you could speak to the chef direct. Problem is a lot of the sauces are made earlier in the day to get flavour depth so you need to know what can be made to you diet.
Made a really good green curry last night that gave me a reading of 5.2 and that was with a shop bought paste and unsweetened cocunut milk thrown in with some onion and pork. Replaced rice with veg. Do you cook? May be the way to go for some types of food. Generally though eating out is fine if you are specific about things when you order (e.g. replace salad dressing with oil and vinegar or dressing on the side, ask for the potatoes or rice to be substituted with a green veg or salad, ask and ask again what is in things - generally places will oblige as they want you back). Another step on the journey.... M

 

[cugila]

Curry's love 'em.......

You really have to experiment with all the things you like best. I find there are many that I can tolerate without too much trouble, it is the Rice, Breads and Potato stuff that I restrict or avoid altogether. Pappadom's are fairly lowish carb so I can manage a couple. Keep the portion sizes down and really there should be not much that is taboo. That's why I eat Low GI/GL......means I have so much more choice of foods. What works for me may not work for you.

One dish, although not a Curry which is great meal is a Tandoori Mixed Grill......lot's of protein and salad........very little carbs at all. Tastes good and certainly is one of my favourites now.

You have to test to see what suits you. I tend to make my own now so I know exactly what goes into it.

Ken.

 

[hanadr]

The best way to eat curry, is to find a recipe you enjoy and make it yourself, modifying if needs be. If buying curries, beware the sauces.
Hana

 

[adm]

The best way to eat curry, is to find a recipe you enjoy and make it yourself, modifying if needs be. If buying curries, beware the sauces.
Hana

Well....I'm a dab hand with a home made curry. I normally make up a tomato, onion and spice based "base" sauce and then add different meat and secondary spices to it to end up with various different dishes. This is pretty much how they do it in most Indian restaurants too.

However, I'm also lucky in that I have three really good Indian restaurants nearby, so often laziness just takes over.

I've gone for the experiment tonight.....ordered a takeaway and have just had a really lovely meal of:

1 poppadum with lime pickle & onion salad
Chicken tikka & salad (with a bit of mint sauce, which I think had sugar in)
King Prawn Jalfrezi
Caulifolower Bhaji
And a few spoonfuls of Tarka Daal (it's like chicken tikka, but a little Otter....badabum!)

So. Tested before, will test in 2 hours and see......

I'm also drinking red wine tonight as commiserations to myself for beign diagnosed with T2. It's Friday night after all. i tried a beer earlier, but after one hour, it had spiked my BG from 7.5 to 13.2......so I thought I wouldn't try any more.

 

[adm]

So, the good news here is that my BG level was 13.2 before dinner, and now 2 hours after an awesome curry and a bottle of red wine, it's 8.2

So - although these aren't great numbers in themselves, it's at least an indication that I can still enjoy curries (even with some poppadoms and daal).

Thank you (insert higher power here)!

 

[adm]

Well, I've now had the first week of knowing I'm a T2 diabetic, testing before and after meals and also going on a low carb diet....

So here's my results and progress so far:

Ooops - looks like the forum isn't configured to accept wide images and the last few days have been cut off. Oh well....the link to the full chart is:

http://gallery.me.com/adentonmiller/100840/Blood Glucose Week One/web.jpg?ver=12725301960001

In case anybody is interested.

The key thing to me is that my Fasting levels started off at 9.0 last Thursday and have slowly but steadily decreased to 6.1 today, with one "blip" yesterday. So this is within the NICE 2010 guidelines, so I am happy with that for a start, but will keep going and see if I can get these levels down to around 5 or so. I presume the Fasting test is the most important one as it shows the results once your body has had a bit of time to work on the glucose in the blood. I can see that results during the day could be bit more varied, but if the Fasting results is too high, then that really means the body can't get the levels down.

My before and after meal tests have also got much closer together over the week as i have begun to learn what foods cause spikes and cut them from my diet. I've been surprised so far with some of the things that cause big spikes - previously foods i thought were good and healthy: wholegrain bread, meusli and fruit salad for instance. I've eaten a lot of meat, cheese, eggs and veg this week though - I've eaten really well and enjoyed my diet without ever feeling hungry. I've also drunk a lot of wine too. Maybe next week I'll cut down on that too. I've only drunk 3 beers over the week though

Anyway. I've been keeping a food diary, so when I have my first appointment with the diabetic nurse next Saturday, I can accurately show her what foods caused the spikes and how my diet has directly affected my BG levels.

The most important thing I have learned this week is "test, test, test". I now have real evidence and can have a sensible discussion with my GP and DN. It's also been a journey of discovery for me - but I have the direct results to prove to myself that what I am doing is working. If I didn't have a meter, I would be eating a lot of foods that I expected to be good for my condition, but in reality I'd be throwing my levels all over the place with no feedback. So for anybody that's newly diagnosed, I'd say - get a meter and get testing. Without the data, you cannot begin to take control.

Finally, a question on target BG levels. The NICE guidelines say 4-7 on waking, and less than 8.5 2 hours after meals. What's the forum's opinion on this? I read that "normal" BG levels are around 4-5 or so, so does it make more sense to aim for this end of the scale rather than being happy within the top end of the guidelines?

 

[Synonym]

Finally, a question on target BG levels. The NICE guidelines say 4-7 on waking, and less than 8.5 2 hours after meals. What's the forum's opinion on this? I read that "normal" BG levels are around 4-5 or so, so does it make more sense to aim for this end of the scale rather than being happy within the top end of the guidelines?

Always best to aim for the lower end rather than the higher end so that if you miss it isn't too far out. 8) Even the most careful of us can be sabotaged by hidden carbs! :evil: